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it's time for "sunday house call." joining us, dr. david samadi, department of urology. >> and dr. marc siegel, nyu lang the medical center and author of the inner pulse, unlock the secret code of sickness and healthy. good morning. >> good morning. >> that's what we do here, unlock it. get you going for the week. >> we start with a incredible study this week. when you go to the doctor, you want to have all sorts of tests

and bring it on, whatever they have. but this study says the common tests and treatments we get may not be necessary. this surprising. >> it is and it's not. it's a continuation of what we talked about a year ago. under the auspices of internal medicine foundation, they decided is 135 tests and procedures may not be necessary. the list is long, no antibiotic for sinusitis. no c-section before 39 weeks. it goes on. no body scan because of radiation. we don't need to get into the tests. of course what we're learning is the whole concept of choose wisely is more is not better. i know marc will talk about how the healthcare system in this country, we're spending more, et cetera, but the way to look at it is doctors are ordering tests

because they're available. number one, we're technologically more advanced so we use them. it's always been a one-way conversation. i'm the doctor, you're the patient. i write the prescription and you do it. >> eric, he wants you to tell folks at home, when they go to the doctor tomorrow, what's the question you should ask? >> do i really need this. that communication is exactly what comes out of this, which is important. there's dangerous news saying you should not get any psa tests if you're healthy. you have to be careful about how you interpret this. i just want to go social security on the defense of doctors because it's always about how doctors order things or tests that may not be necessary. there's a cloud of malpractice over every doctor. a lot of them in their heart know this patient may or may not

need an mri or cat scan. if you change the system where doctors are more comfort alec the tests will go out the door. >> if the dr. -- doctor said you need this, we do it. >> when we started this, i was negative because guidelines don't appeal to me. now 17 more associates are added to this and i like what the american board of internal medicine is doing. reaching out and saying which tests do we need to worry about. doctors practice in a culture of fear. not just that they may get sued for a particular thing. who knows if the one in a thousand persons has it. what this is about is furthering a conversation between the doctor and patient.

the patient comes in and says do i need that test. i just read 5% of children who go to the emergency room who hit their head get a cat scan. only if you black out do you need one. the american college of cardiology says maybe too many stress tests are order leading to too many angiograms. it's not the test that leads to the test, it's the doctor. we've gone over most of these and pointed out, you know, it's a one-on-one decision. today we're talking thyroid disease and it's underorder. >> so bottom line is, ask your doctor if you really need it. >> bring back the clinical diagnosis, which i'll ask you about. new information on a thunderstorm of thyroid disease that affects millions of americans, women in particular. hypothyroidism. when it's severe, you have

weight gain, reduced chance of becoming pregnant. dr. siegel, women and men who love them want to take care of this. >> we have at least 10 million people in the united states with low thyroid. in 10% of women, they have this at least. it's something you worry about when you're pregnant and as you get older, chances increase. the number one cause is hatchy moto. the gland gets inflamed. you make antibodies. your body targets your thyroid gland right here in the front of your neck. that's where it is. and your body targets it and makes antibodies and it doesn't function as well. now, how do you know if you have it? i tell people the number one symptom i'm on the lookout for is fatigue. when people are tired, depressed, losing energy. their hair is falling out, their skin -- they don't tolerate

cold. they get constipated. those are symptoms of low thyroid. that's one of the main things i see so i screen everyone that comes in for thyroid. >> it should be a standard panel, shouldn't it? if it changes as you get older. >> if you make it standard, we'll order a lot of test around somebody's going to say why did you order this? you have to first examine the patient then get the test later. look. >> how do you fix it? >> first we need to diagnose it. the best test is to get your t3 test, the active thyroid. followed by t4 and thyroid stimulating hormone. thyroid is important. a lot of people wanted this topic because of obesity. more so than anything. of course you've going for dry skin and hair loss but a lot of people are fatigued. they're gaining weight without

eating. check your reside. you -- the thyroid is connected to the adrenal gland. if you're under stress your cortisol level is up and prevents thyroid conversion. >> do you believe in preplacing it? are there precipitation and -- prescription and natural methods? >> celineum is one of the things that converts t4 to t3 and boosts the thyroid. synthroid is medication. people on the east coast of the u.s. melatonin is high during the winter and brings down your thyroid. so find one of those lights, sit in front of them for about half an hour to boost your thyroid. >> interesting. >> you like that. >> well, it's natural. >> two points. first of all i would test this

in women for sure. thyroid stimulating hormone is the brain struggling to get the gland to work. in terms of replacing it, i believe for throw thyroid, since the replacement is safe and the results are dramatic, i wouldn't use herbal treatments. if you are low and it shows on a blood test i would use thyroid replacement. >> one of the things that came out is your doctor may say that your thyroid hormones are normal but it could be a low normal. to you may have to have a conversation to boost it. >> it's tied to metabolism. >> it's really important. you know it's the weekend. you're throwing the football or shooting hoops in the driveway. well, if you're a weekend warrior, there's a painful sports injury more and more

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thanks. that's the cold truth! back with "sunday house call." nearly 1 million appearance received medical care for shingles, a painful blistering skin rash caused by a virus, the same one that causes chicken pox. a viewer says i recently came down with shingles and was surprised because i was never diagnosed with chicken pox as a child and did not get the vaccination. how common -- how many millions of americans get shingles? >> about a million of americans are effected. it's a reactivation of chicken

pox, herpes glossier. the rash becomes painful and blisters follow with and you get newerralgia. it appears on the side of the body where there's a derm atome. if you haven't had chicken pox and touch someone with shingles, you may get chicken pox, not the shingles. if you have had had chicken pox and got the shingles, do you need vaccination? these are all controversial debates. the jury is out. marc is going to say it's better to get the vaccine. i think the recurrence after having shingles is very low. if you're over 60, you can go ahead and get the vaccine. >> if i go to the doctor, what do i say? >> we covered this before, you got to know whether you had chicken pox. first thing you do a get a blood

test. i can prove if you've had it. most americans have had chicken pox. >> i have no idea. >> a lot of people probable -- people think they had it and it was something else. you have to get it checked. if you have had it, you're at risk for shingles. the agree the shots are meant for people who had chicken pox but never shingles. it cuts down our risk of getting it by 50%. if you get it, it cuts done on severe cases by a significant amount. this vaccine is underutilized. you can't give it to people with h.i.v., carries, or people who are pregnant. >> this patient, i have to examine him. >> i would do a full workup. >> if you're over 50 and have

had chicken pox, you should have it. >> the patient -- >> got to go. good luck getting an appointment with these guys. new questions about the growing number of athletes reporting sports hernias. i asked whether or not women get it too. we'll give you that answer. how do you avoid a hernia when you're just working out? look, if you have copd like me, you know it can be hard to breathe, and how that feels. copd includes chronic bronchitis and emphysema. spiriva helps control my copd symptoms by keeping my airways open for 24 hours. plus, it reduces copd flare-ups. spiriva is the only once-daily inhaled copd maintenance treatment that does both. spiriva handihaler tiotropium bromide inhalation powder

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on one hand you're told to get out on the weekend and exercise. now there's concern over sports hernias. what is is it? why haven't we heard much about it. dr. siegel spoke to a top expert. >> the injury is common. if you combine those with hip problems we see, the interarticular hip issues, it probably rivals knee injuries and shoulder injuries. understanding the anatomy is key. there's lots of muscles and ways they can intertwine. and it's not conventionally tied

to skills. >> when either of you doctors talk to an expert, we take notice. this is obviously a big issue. >> i'm going to throw this to dr. mattie. in medical school we learn this but when we come out, surgeons stick to the anatomy. we talk about the physiology. dr. meyers says the pelvis is a tight compartment. bones, nerves, muscles all crammed together. if you're doing sports and overusing a muscle group, you can tear the muscle. if you tear the muscle, you might not know so you try physical therapy, heat, anti-inflammatories and you get worse. that happened to andyan peterson and donovan mcnabb but it happens to high school students and college students. they don't know what to do.

mri scans show tears. the concept of sports hernia is a misnomer. we used to thing was a the bowel wall breaking through the muscles but in most of these, it's a tear in the muscle. if it doesn't get better, dr. meyers and others are using a lap are -- lapra scope. he does an elegant procedure. >> we were talking about robotics. you would operate laparoscopically. if it's a tear, which i didn't but if it's a tear, how do you repair it, surgically? >> what the americans do, compared to europeans, we use a lot of mesh. hernia is a protrusion and a break in the ring in the

inguinal canal that. hernia, you can examine it and clinically find where it is. this is a different type of hernia. this is like a psuedo-hernia, as a result of wear and tear of playing football, hockey and soccer players, when you twist really fast, you can tear a muscle. it becomes almost like a herniation. a lot of german surgeons are doing this repair, but they are not using mesh. the americans have laparoscopic repair. i think a lot with rest and ice pack, et cetera, the inflammatory process, can recover on its own. but the pelvic area and the whole anatomy is very, very complex. every time do i this robotic prostate surgeries, we will see the anatomy very clearly. >> that's so interesting. so we know another hernia type to look for. we will have a lot more when we

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